USPS PS 3600-FCM Template

United States Postal Service

Draft Redline 05/13/21

Postage Statement--First-Class Mail

and First-Class Package Service

Use this form for First-Class Mail and First-Class Package Service.

Permit Holder Name, Address, Email, Telephone

Mailing Agent (If other than permit holder)

Name, Address, Telephone

Post Office: Note Mail Arrival Date & Time (Do Not Round-Stamp)

Mail Owner (If other than permit holder)

Name, Address

Mailer

Mailing

Postage

Certification USPS Use Only

CAPS Cust. Ref. No.

CRID

CRID

CRID

Post Office of Mailing

Mailer's Mailing Date Federal Agency Cost Code

Statement Seq. No.

Permit #

No. and type of Containers

Sacks

Type of Postage Processing

For Mail Enclosed

Weight of a Single Piece

SSF Transaction ID#

Parcels Only Hold

Permit Imprint Precanceled

Category Letters

within Another Class Marketing Mail

.

pounds

For Pickup (HFPU) No. of pieces

1 ft. Letter Trays

Stamps

Flats

Bound Printed Matter Total Pieces

Total Weight

2 ft. Letter

Metered

Parcels

Library Mail

Customer Generated Electronic Labels

Trays

Move Update Method

Periodicals

Letter or flat-size mailpieces contain:

SigCon

EMM Letter Trays

Ancillary Service

Alternative Method

Media Mail

Round Trip ONLY: One DVD/CD or other disk.

For Automation Price Pieces,

Flat Trays

Endorsement NCOALink ACS

Multiple

OneCode ACS

n/a Alternative Address Format

Combined Mailing Single Class

This is a Political Campaign Mailing

Yes

No

This is Official Election Mail

Yes

No

Enter Date of Address Matching and Coding

/ /

Parts Completed (Select all that apply):

A

B

C

D

S

NSA

T 1

2 Price at Which Postage Affixed (Check one). Correct

Lowest

Complete if mailing includes pieces bearing metered/PC Postage.

3

Neither

Subtotal Postage (Add parts totals)

pcs. x $

.

= Postage Affixed -

Incentive/Discount Flat Dollar Amount -

F 4

Fee Flat Dollar Amount +

5 Permit #

Net Postage Due (Line 1 +/- Lines 2, 3, 4)

Pallets Other

A Additional Postage Payment (State reason)

For postage affixed, add additional payment to net postage due; for permit imprint, add additional payment to total postage.

R Postmaster: Report Total Postage in AIC 121 (Permit Imprint Only)

Postmaster: Report Total Postage in AIC 128 (Permit Imprint Only)

Total Adjusted Postage Affixed

Total Adjusted First-Class Mail Postage Permit Imprint Total Adjusted First-Class Package Service Postage Permit Imprint

Incentive/Discount Claimed:

Type of Fee:

D The mailer's signature certifies acceptance of liability for and agreement to pay any revenue deficiencies assessed on this mailing, subject to appeal. If an agent signs this form,

the agent certifies that he or she is authorized to sign on behalf of the mailer and that the mailer is bound by the certification and agrees to pay any deficiencies. In addition,

agents may be liable for any deficiencies resulting from matters within their responsibility, knowledge, or control. The mailer hereby certifies that all information furnished on this

form is accurate, truthful, and complete; that the mail and the supporting documentation comply with all postal standards and that the mailing qualifies for the prices and fees

claimed; and that the mailing does not contain any matter prohibited by law or postal regulation. I understand that anyone who furnishes false or misleading information on this

form or who omits information requested on this form may be subject to criminal and/or civil penalties, including fines and imprisonment.

Privacy Notice: For information regarding our Privacy Policy visit .

Signature of Mailer or Agent

Printed Name of Mailer or Agent Signing Form

Telephone

Weight of a Single Piece

.

pounds

Total Pieces

Total Weight Total Postage

Are postage figures at left adjusted from mailer's

entries?

Yes

No If yes, reason:

Round Stamp (Required) Payment Date

Presort Verification Performed? (If required) Yes

No

I CERTIFY that this mailing has been inspected for each item below if required: (1) eligibility for postage prices claimed; (2) proper preparation (and presort where required); (3) proper completion of postage statement; (4) payment of annual fee; and (5) sufficient funds on deposit (if required)

USPS Employee's Signature

Date Mailer Notified

Contact

By (Initials)

Time

Print USPS Employee's Name

AM PM

USPS Use Only

To be completed in non-PostalOne! sites

PS Form 3600-FCM, August 2021 (Page 1 of 6) PSN 7530-13-000-5569

This form and mailing standards are available on Postal Explorer at pe..

First-Class Mail

Part A -- Automation Price

Postcards (eligible for postcard price)

A1 5-Digit A2 AADC A3 Mixed AADC

Price

No. of Pieces

Subtotal Postage

Discount Total*

Fee Total

Letters

A4 5-Digit A5 AADC A6 Mixed AADC

Price

No. of Pieces Subtotal Postage

Discount Total*

Fee Total

Flats

Price

No. of Pieces Subtotal Postage

Discount Total*

Fee Total

A7 5-Digit A8 3-Digit A9 ADC A10 Mixed ADC

* May contain both Full Service Intelligent Mail and other discount--see Instructions page for additional information.

T A11 Part A Total (Add lines A1 -- A10)

Full Service Intelligent Mail Option

F A12

DISPLAY ONLY

A13

DISPLAY ONLY

DRA A14

DISPLAY ONLY

Postcards -- Number of Pieces that Comply ____________ x $0.003 Letters -- Number of Pieces that Comply ____________ x 0.003 Flats -- Number of Pieces that Comply ____________ x 0.003

Total Postage Total Postage Total Postage

PS Form 3600-FCM, August 2021 (Page 2 of 6)

First-Class Mail

Part B -- Nonautomation Price

Postcards (eligible for postcard price)

B1 Presorted B2 Single-Piece

Price

No. of Pieces Subtotal Postage Discount Total Fee Total

Machinable Letters

B3 AADC

B4 Mixed AADC

Residual

B5

From First-Class Mail Mailing (Includes up to 1 oz. and between 1 oz. and 3.5

oz.)

B6 Nonpresorted/Single-Piece*

B7

Single-Piece From USPS Marketing Mail Mailing

Nonmachinable Letters

B8 5-Digit B9 3-Digit

B10 Mixed ADC

B11 Nonpresorted/Single-Piece*

B12

Single-Piece From USPS Marketing Mail Mailing

Flats

B13 Presorted

B14 Single-Piece

B15

Single-Piece From USPS Marketing Mail Mailing

Permit Reply Mail

B16

Single-Piece Letters (1 oz. or less)

B17

Single-Piece Letters (over 1 oz. to 3.5 oz.)

B18

Single-Piece Flats (1 oz. or less)

B19

Single-Piece Flats (over 1 oz. to 13 oz.)

Price

No. of Pieces Subtotal Postage Discount Total Fee Total

Price

No. of Pieces Subtotal Postage Discount Total

FT Price

No. of Pieces Subtotal Postage Discount Total

DRA Price

No. of Pieces Subtotal Postage Discount Total

Fee Total Fee Total Fee Total

* First-Class Mail metered letter price ** Only on FCM letters with one or more nonmachinable characteristics

Total Postage Total Postage

Total Postage Total Postage Total Postage

B20 Part B Total (Add lines B1 -- B19)

PS Form 3600-FCM, August 2021 (Page 3 of 6) PSN 7530-13-000-5570

First-Class Package Service

Part C -- Parcels

Commercial Parcels less than 16 oz. (1 lbs.)

Zone

C1

1 & 2

C2

3

C3

4

C4

5

C5

6

C6

7

C7

8

C8

9

C9

Irregular shape surcharge

Price

No. of Pieces

Subtotal Postage

Discount Total

Fee Total

Commercial Parcels -- NSA

Zone

Price

No. of Pieces Subtotal Postage

Discount Total

Fee Total

C10

1 & 2

C11

3

C12

4

C13

5

C14

6

T C15

7

C16

8

C17

9

F C18

Irregular shape surcharge

Commercial Parcels -- NSA

Zone

A C19

Single-Piece

C20

Irregular shape surcharge

Price

No. of Pieces

Retail Parcels 13 oz. (0.8125 lbs.) or less

R Zone

C21

1 & 2

Price

No. of Pieces

C22

3

D C23

4

Subtotal Postage Subtotal Postage

Discount Total Discount Total

Fee Total Fee Total

C24

5

C25

6

C26

7

C27

8

C28

9

Retail Parcels 13 oz. (0.8125 lbs.) or less from USPS Marketing Mail

Zone

C29

1 & 2

Price

No. of Pieces Subtotal Postage

Discount Total

C30

3

C31

4

C32

5

C33

6

C34

7

C35

8

C36

9

Fee Total

C37 Part C Total (Add lines C1 -- C36)

PS Form 3600-FCM, August 2021 (Page 4 of 6)

Total Postage Total Postage Total Postage Total Postage Total Postage

Round Trip DVD, CD, or Other Disc Mail

Part D -- Round Trip Mailing that Contain a DVD, CD, or Other Disc

Automation Letters

D1 5-Digit D2 AADC D3 Mixed AADC

Price

No. of Pieces Subtotal Postage

Discount Total*

Fee Total

Presort Letters

D4 Presorted D5 Single-Piece

Price

No. of Pieces Subtotal Postage

Discount Total

Fee Total

Automation Flats

Price

No. of Pieces Subtotal Postage

Discount Total*

Fee Total

D6 5-Digit

D7 3-Digit

D8 ADC D9 Mixed ADC

Presort Flats

D10 Presorted

T D11 Single-Piece

Price

No. of Pieces Subtotal Postage

Discount Total

Permit Reply Mail

F D12

Single-Piece Letters (1 oz. or less)

D13

Single-Piece Flats (2 oz. or less)

Price

No. of Pieces Subtotal Postage

Discount Total

A * May contain both Full Service Intelligent Mail and other discount--see Instructions page for additional information.

Fee Total Fee Total

D14 Part D Total (Add lines D1 -- D13)

R Full Service Intelligent Mail Option

D15

DISPLAY ONLY

D D16

DISPLAY ONLY

Letters -- Number of Pieces that Comply ____________ x $0.003 Flats -- Number of Pieces that Comply ____________ x 0.003

Total Postage Total Postage Total Postage

Total Postage Total Postage

PS Form 3600-FCM, August 2021 (Page 5 of 6) PSN 7530-15-000-7023

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